Bromley Road Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence.

At our last assessment we rated this key question good. At this inspection, the rating has remained the same.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored this quality statement 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients received comprehensive multidisciplinary assessments that considered their mental health, physical health, social circumstances, rehabilitation needs and longer-term recovery goals. Assessments were person-centred and informed by Positive Behaviour Support planning and psychological formulation. The care management plans included input from a range of professionals such as General Practitioners (GPs), Occupational therapy, Dieticians, nursing, medical, Psychologists, Speech and Language therapists to meet individual needs.

Staff developed holistic care plans for each patient that reflected their individual needs, strengths and preferences. Care plans addressed a broad range of areas, including mental health needs, physical healthcare, medicines management, risk management, psychological wellbeing, daily living skills, social inclusion, community access, education, vocational opportunities, and discharge planning. Records demonstrated that patients were involved in developing their care plans and, where appropriate, the views of families and carers were sought and incorporated into care planning and treatment decisions.

Staff demonstrated a good understanding of patients' histories, current needs and recovery aspirations. Patients' strengths, protective factors and opportunities for developing greater independence were recognised and reflected within care planning processes. Positive Behaviour Support plans and psychological formulations provided staff with a clear understanding of the factors influencing behaviour and the strategies required to support patients effectively.

The Responsible Clinician and wider multidisciplinary team were actively involved in assessing, reviewing and planning patients' care and treatment. Multidisciplinary meetings brought together contributions from psychology, nursing, occupational therapy, medical and other allied health professionals to ensure care remained coordinated, responsive and focused on rehabilitation outcomes. This collaborative approach supported personalised care delivery and helped patients make progress towards their recovery and independence goals.

We scored this quality statement 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation, current evidence-based good practice and standards.

The service delivered care through a rehabilitation model supported by structured assessment, treatment and transition pathways. Patients were admitted to either a treatment-engaging or treatment-resistant pathway, enabling care and therapeutic interventions to be tailored to their individual needs, presentation and recovery goals. Progress through the service was supported by regular multidisciplinary reviews, rehabilitation planning and discharge preparation, with a clear focus on increasing independence and supporting successful transitions to less restrictive community settings.

Positive Behaviour Support (PBS) planning was a notable strength of the service and formed a central component of treatment and rehabilitation planning. PBS plans were informed by comprehensive psychological assessment and formulation and reflected patients' strengths, triggers, communication needs, coping strategies and support requirements. Plans provided staff with clear guidance on proactive interventions, early warning signs of distress and personalised approaches to reducing behavioural escalation. Patients were involved in the development and review of their PBS plans, and records demonstrated efforts to ensure patients' views, preferences and goals were reflected in care planning. Staff told us that PBS plans helped them better understand individual triggers and support needs, enabling more consistent and effective care.

The service demonstrated a commitment to using PBS plan to promote recovery, minimise restrictive practices and support positive risk-taking. Staff described how patients' risks, self-harm triggers and support needs were regularly reviewed with their primary nurse and discussed within the multidisciplinary team. Staff also reported that PBS approaches had contributed to reductions in incidents of behavioural escalation and restrictive interventions by improving staff understanding of individual needs and encouraging proactive support strategies. Audit processes demonstrated that PBS plans were completed, reviewed and embedded within wider care planning and risk management arrangements.

Staff used recognised therapeutic approaches, including cognitive behavioural therapy, motivational interviewing, trauma-informed practice and formulation-led interventions, to support emotional wellbeing, behavioural understanding and recovery.

The percentage of staff that received regular supervision for permanent staff was 92% and 100% for bank staff across both wards.

The percentage of staff that had an appraisal in January and February 2026 was between 81 to 85% across both wards.

We observed effective multidisciplinary working between the Responsible Clinician, psychologist, occupational therapist, nursing staff and support workers during discussions about patients' progress, rehabilitation goals, risk management and discharge planning. This collaborative approach helped ensure treatment remained holistic, coordinated and responsive to patients' changing needs.

Patients had access to education, meaningful community activities, physical healthcare support and therapeutic programmes designed to build confidence, resilience and independent living skills. Multidisciplinary reviews considered patients' progress towards rehabilitation goals, community engagement, daily living skills and readiness for discharge. This supported patients to develop greater independence and make progress towards less restrictive living arrangements and improved quality of life.

We scored this quality statement 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Multidisciplinary working was a notable strength of the service. Psychiatry, nursing, psychology, occupational therapy and other healthcare professionals worked collaboratively to deliver holistic care and support patients' rehabilitation and recovery goals.

Staff held regular and effective multidisciplinary team meetings. Multidisciplinary team (MDT) discussions demonstrated effective communication, shared decision-making and active clinical leadership. Daily meetings included discussions about individual patients, current risks, progress against treatment goals, physical health needs, external referrals and discharge planning. Staff used these meetings to review patients' progress, coordinate interventions and ensure care remained responsive to changing needs.

We observed evidence of effective partnership working with external healthcare providers to support patients' physical and mental health needs. For example, records showed timely referrals to specialist services, including dentistry for patients experiencing tooth pain, dietetic services, diabetic specialist nurses and oncology services for screening and follow-up care where required. This helped to ensure patients received coordinated and comprehensive healthcare.

Patients benefited from a joined-up approach to risk management, rehabilitation and discharge planning. For example, MDT reviews considered patients' progress in developing daily living skills, community access, medication management and independent living abilities alongside their mental health recovery.

Discussions brought together contributions from nursing, psychology, occupational therapy and medical staff to identify barriers to discharge and agree actions to support progression. This collaborative approach helped ensure patients were supported to achieve greater independence and move successfully to less restrictive environments when clinically appropriate.

We scored this quality statement 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service promoted patients' physical health and wellbeing through effective monitoring arrangements, health promotion initiatives and collaborative working with external healthcare providers. Since the previous assessment, the service had strengthened its approach to physical healthcare and addressed the previous recommendation relating to the monitoring of patients receiving high-dose antipsychotic therapy (HDAT).

A dedicated physical health lead provided effective oversight of physical healthcare across the service. The physical health lead monitored compliance with physical health checks, supported staff in identifying and escalating concerns, reviewed monitoring requirements and provided assurance through audit and governance processes. Staff demonstrated a good understanding of physical health monitoring and escalation procedures and were able to describe the support available from the physical health lead. These arrangements provided greater assurance that patients' physical health needs were being identified, monitored and managed appropriately.

Records showed that patients prescribed high-dose antipsychotic therapy received the required physical health monitoring, including blood tests and other relevant health checks. Staff acted appropriately when abnormal results were identified and escalated concerns to medical professionals and specialist services as required. This demonstrated that the provider had taken effective action to address the concerns identified at the previous assessment.

Staff worked proactively with GPs, community healthcare teams and specialist services to ensure patients received timely access to assessment, treatment and ongoing healthcare support. We found evidence of referrals to a range of external services, including dental services for patients experiencing oral health concerns, dietetic services to support nutritional needs, diabetes specialist teams for the management of long-term health conditions and oncology services for screening and specialist follow-up. Staff maintained oversight of referrals and follow-up appointments and coordinated care across different services to ensure patients received appropriate treatment.

Partnership working improved access to healthcare and supported an integrated approach to meeting patients’ physical and mental health needs. Patients were encouraged to engage in health promotion, exercise and wellbeing activities, supporting recovery and positive health outcomes.

We scored this quality statement 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service monitored patients' progress through regular care reviews, multidisciplinary team (MDT) meetings, rehabilitation milestones and governance processes.

Staff provided a range of treatments and interventions based on national guidance and best practice, including psychological therapies, support with self-care, development of daily living skills, community engagement and meaningful occupation.

Staff also supported patients to manage their physical health and encouraged healthier lifestyles through health promotion activities and access to specialist healthcare services.

Staff used recognised outcome measures to assess and record the severity of patients' conditions and to evaluate treatment outcomes. For example, the psychology team used validated outcome measures to monitor changes in anxiety and depression symptoms and assessed the development of individual intrapersonal skills over time. Outcome measures were reviewed alongside clinical observations, risk assessments and rehabilitation goals to help inform treatment planning and measure progress.

We saw evidence of positive outcomes for patients, including increased independence, greater engagement in education and meaningful activities, progression in community access and leave arrangements, and improvements in mental health stability. MDT reviews considered patients' progress towards rehabilitation goals, identifying barriers to recovery and agreeing actions to support further development and independence.

Leaders demonstrated a commitment to quality improvement and ongoing service development.

Staff participated in clinical audit, benchmarking and quality improvement initiatives to evaluate the quality and effectiveness of care. The service used information from audits, outcome measures, incidents and patient feedback to identify opportunities for improvement and monitor performance.

Developments in care planning, physical healthcare oversight and partnership working with external agencies reflected a continued focus on improving patient outcomes, enhancing rehabilitation pathways and supporting successful transitions to less restrictive environments.

We scored this quality statement 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service delivered care within an appropriate legal framework and had systems in place to support compliance with the Mental Health Act 1983 (MHA) and Mental Capacity Act 2005 (MCA). Staff demonstrated a good understanding of the principles of the MCA and were able to explain how consent, capacity and best-interest decision-making informed care and treatment. Staff also understood their responsibilities under the Mental Health Act and the Mental Health Act Code of Practice and applied these appropriately in practice.

Staff had completed training relevant to their legal responsibilities, including Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) training, with compliance at 94.4% at the time of inspection. Compliance with Mental Health Act Code of Practice training was 96%, providing assurance that staff had the knowledge required to support patients' rights and legal safeguards. Staff were aware of how to access specialist advice when required.

Patients were generally involved in decisions about their care and treatment. We observed examples of collaborative clinical discussions and shared decision-making. Treatment documentation was present within the records reviewed, and systems were in place to monitor compliance with both the MHA and MCA. Audit findings indicated that detention procedures and consent to treatment arrangements were applied lawfully and appropriately recorded.

However, we identified some inconsistencies in the accessibility and traceability of legal documentation. Mental Health Act audits had identified omissions relating to capacity assessments associated with treatment decisions, Section 132 rights documentation, aspects of tribunal outcomes and detention renewal records. In some patient records, documentation relating to capacity assessments and clinical decision-making was not readily accessible. These issues related primarily to record-keeping and governance assurance rather than the application of the legislation in practice. Staff were able to describe patients' legal status, rights and relevant decision-making processes. We found no evidence that patients' rights or care had been adversely affected.